Catherine Forsythe

Catherine Forsythe
know a bit about computer security, dogs, horses, skiing, medicine and making risotto. My nickname in real life/online is "Noggie" - I'm on Twitter, with the @dogreader account.

Editor’s Pick
APRIL 22, 2010 11:48AM

Dr. Ann McKee May Be Able to Explain Ben Roethlisberger

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For Ben Roethlisberger, football quarterback, there were no criminal charges of sexual misconduct. There were only allegations - repeated allegations from different sources. In the court of public opinion, Roethlisberger has been pilloried. Many fans of his Pittsburgh Steelers consider him a lout and an embarrassment to a revered football franchise, steeped in tradition. Based on his conduct, Roethlisberger has been suspended by the NFL for six games. Certainly, that will be appealed. The suspension is without pay and could total to "losing $2.8 million in salary". It certainly does not help that there are pictures on the internet with Roethlisberger wearing a "Drink Like a Champion" t-shirt

To many sports fans, Roethlisberger's alleged behaviour has been inexplicable - and despicable. Roethlisberger is a young, talented athlete who has fame and wealth. Why would be place himself into such predicaments? And why would he do so repeatedly?

The answer for Roethlisberger and many other present and past football players may rest with medical findings.  

Dr. Ann McKee knows football. She was a Green Bay Packer fan in former years. She knows American football from the perspective of a fan and from the perspective of a medical doctor. She is one of the United States' foremost neuropathologists. For decades, she has examined brain tissue of deceased people. Among the brain tissue that she has examined are those of former football players. The medical data are significant. In testimony before Congress, Dr. McKee said:

"...  I can say that for the past 23 years, I have looked at thousands of brains, from individuals from all walks of life, of all ages, and during the past 20 years, I have primary focused on abnormalities of tau protein. But I have see this unique pattern of change, in this severity, in individuals with a history of repeated head trauma, including boxers and football players. These changes are dramatically not normal - there is no way these pathological changes represent a variation in normal that we find under the bell shaped curve..."

The compromised brain may lead to memory problems, personality changes, depression and a whole host of physical impairments. A survey conducted in 2009 concluded that concussions were "inevitable"

Through Roethlisberger's career in football from a very young age, he has sustained vicious blows to the body, not just to the head. The blows to the body also impact the brain structure. The head feels the force of the tackles. Roethlisberger reportedly has had four concussions in four years, as well as a significant motorcycle accident where he sustained a broken jaw and broken nose among other injuries. He was not wearing a helmet.

This is not an apologist's excuse for Roethlisberger's alleged behaviour. The public is tired of sexual misconduct followed by an admission of need for sexual addiction therapy. One wonders when a bank robber will plead with the courts that the theft was a result of 'bank robbery addiction'. 

The work of Dr. McKee and other medical researcher indicate that there is a real and significant danger in playing football. There is empirical evidence. The repeated blows to the body can have a cumulative effect. Further, there is the masculine image of toughness in playing through pain and overcoming injuries. It supposedly shows character. It also may exacerbate brain damage, change quality of life and even shorten one's life. 

While the allegations against Roethlisberger are deplorable, there may be some positive contributions from this maelstrom. Roethlisberger's alleged 'questionable' behaviour may not be a matter of character. It may be the early indication of a serious neurological problem in a very talented young athlete. 

Catherine Forsythe 
Dr. Ann McKee: Presenting the Data

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This analysis might be a bit of a stretch, since a lot of guys in non-contact activities are also loutish, but it does link to a serious problem - the long-term effects of the violent play that so many of us cheer for on Sunday afternoons. I've read too many stories about former football players suffering from psychological and neurological damage while still fairly young. The NFL has been very slow to take it seriously.
Bonnie, IF there is a neurological component, the alcohol would have a powerful impact. This is a man who is paid for his judgement in critical on-field situations. There must be some explanation why judgement is so impaired.

CC, it does not preclude that there are both neurological and personality factors in play here. It may take the impact of these cumulative injuries to a contemporary star athlete, such as a championship quarterback, to have the NFL make some significant changes.
Brain injury is a serious problem in many contact sports not given due attention. Thanks for the article.
I played the YouTube video. I had no idea that it effected people so young!
Correlation does not equal causation. You don't develop a sense of entitlement as a college and professional athlete from taking shots to the head. By logical extension, how many concussions did OJ Simpson have?

This is a great post to launch a philosophical discussion, Noggie. I don't support conclusions, but I love this as a springboard for discussion.
Kathy, needless to say that focus on this issue is not good for business. And there is absolutely no doubt that football is big business.

Eve, there are a couple of men in the background, in that video, who obviously do not want to be there. They are yawning and sleepy.

OES, I will have to disagree with you here. Dr. McKee's evidence is not statistical correlation at this point. There is enough empirical evidence to say confidently that it is causal. I think that the error that many people will fall into is to think that this is an "either/or" situation. It is not. A neurological impairment may be a contributing component. Alcohol may play a part. Personality may be a factor. And yes, morality, misogyny and motherhood can be part of the discussion.

I think that simply calling him a reprobate does not focus on the cause. His alleged behaviour may be despicable but, at some point, the NFL is going to have to look at Roethlisberger's actions, the early dementia of former athletes, the memory loss of relatively young men and ask why is this happening.

And finally, thanks to all who I see commenting here. You regularly add to the discussion and I just wanted to say "thank you!".
I agree that her argument is empirical. Certainly the strange behavior of former Patriots lineback Ted Johnson is attributed to the head injuries he suffered as a player.

I guess I was trying to make this point. Some successful athletes gain recognition and a sense of entitlement as they climb the ladder of success in high school, college and the pros.

Could head injuries be a factor in impaired judgment? Yes, I believe it could be a factor. Is coddling by high school. college, professional coaches, the media, sportsagents also a factor in creating these self absorbed ruffians? Yes, to that too.

I used OJ Simpson as a comparison to Rothlisberger as an example. Both were successful athletes at their respective positions. Both have had incidents with the law. Both have done really stupid things, Ben's motorcycle accident, and OJ's armed assault in Vegas.

While Simpson was acquitted of criminally killing his wife, and held responsible for her death in civil court, would you have thought head injuries were a cause for this behavior? You didn't comment I was curious. Thanks.
Also, Ben had hired off duty law enforcement officers to escort him. This, in theory, seems prudent. They kept him from adding a DWI to the mess. But the fact that not only did they not keep him out of this mess, they seemed to have contributed to it. That strikes me as the single most odious aspect of this situation.
This post is a good marriage of science, behavior and sport. I know someone who works with traumatic brain injury patients and it is incredible the effects and trauma from those injuries. How sad, and how dangerous this sport is. Gladiators. Hmmm. Rated.
nice piece with a different perspective on the story. football players do take an extreme amount of physical punishment on the field, but i'd hate to start seeing them use that as an excuse for poor behavior. that said, i think it's important that the league takes head injuries more seriously and work on removing the stigma of sitting out a few games when the body and brain need a rest. i think a combination of factors are at work in this particular case.
OEsheepdog, when the O.J. Simpson trial was happening, I was too young to take any interest. I haven't read enough about his football injuries to form any solid opinions. However, since he was such a dangerous running back, there must have been some extra effort every time that he could be caught.

Simpson could make a valuable contribution to this problem. He could consent to have his brain examined after death. That is something that all professional football players could do to further the understanding of the damage encountered by playing the game.

Let me say again that this is not a "get-out-of-jail-free" card. The neurological damage can be a contributing factor. The important question to many people would be whether to allow a son to play the sport. Is the trade-off worth it: fame and instant wealth versus a possible shorten life span and a premature decreased quality of life? The intervening variable is that these young men thank that they are bullet-proof. They think that it can never happen to them. And the culture feeds into their being 'special' and gifted athletes. The perspective changes.

Perhaps, for parents, encouraging work on that jump shot and those low post moves look much more appealing.
This was beginning to be known when my older children were in high school. A classmate of one of my daughters, a high school quarterback, experienced dramatic negative changes in both cognitive function and personality, has been convicted of several crimes of violence, and today is not able to live independently. He is 23 or 24.

That doesn't rule out other causes for Roethlisberger's behavior, but it's a persuasive argument for greater protections against repeated concussions, especially in young athletes. Roethlisberger might well choose to take the risk; high school students should not make the choice on their own.
Paging Mike Tyson, Paging Mike Tyson.

Excellent perspective. In the military the term is "traumatic brain injury" or TBI for our soldiers returning from Iraq and Afghanistan. There is a whole host of protocols for them as well as education to their families on what to expect. At least, they are supposed to be doing this for our soldiers. It would be great to extend that to football players. I do know football players suffer serious arthritis also in their later years from all of their injuries. I first heard about that from Joe Namath.
Excellent, well rounded post.
There's been successive segments on Bryant Gumbel's show about concussions in the/and the NFL.

and here's an article from HuffPo:


and good old AARP:
Not only will bank robbers go into rehab for Bank Robber's Disease, they will also find Jesus Christ.
Or it could be all that money and millions of people's adoration.
How many hits to the head did Tiger Woods have before he had to face the music?
This isn't happening only to pros. There are two very interesting pieces on brain injury in athletes, mostly NFL players (especially linemen) in GQ and The New Yorker.

Bennet Omalu's work is profiled in the GQ piece, along with the NFL's attempt to deny and minimize his findings. All seventeen of the brains of the ex-NFL players he pathologically examined showed a high build up of tau, the protein that accumulates in the brain cells of second stage Alzheimer’s patients, killing the cells and eventually the patient. Almost all of the ex-players whose brains he examined exhibited dementia in the last few years of their lives. Dr. Omalu named the syndrome "...chronic traumatic encephalopathy (C.T.E.), which is a progressive neurological disorder found in people who have suffered some kind of brain trauma..." in the paper "Chronic Traumatic Encephalopathy in a National Football League Player". It was published by Neurosurgery in May 2006.

Ann McKee's work is referred to in the New Yorker article. She has done pathological examinations of the brains "...of sixteen ex-athletes, most of them ex-football players..." and, although she says "...she will need to see at least fifty cases before she can draw any firm conclusions...", she is also seeing a high build up of tau. She saw this in every one of these sixteen brains she's examined.

Julian Bailes, "...a neurosurgeon of considerable renown who had for a decade worked as a Steelers team doctor...", has worked with Dr. Omalu since the publication of "Chronic Traumatic Encephalopathy in a National Football League Player". "...I told the NFL, I said, 'Why don't you take the head out of the game? Just take it out of the game! Let the linemen start from a squatting position instead of getting down for head-to-head. Have them stand up like they do on pass protection. So there’s not this obligatory head contact.'"

If football is to continue being played, this change must be made. It's cruel and inconceivable that millions of people (most of whom will never make the pros) will suffer brain injury, affecting them for the rest of their lives, in order to develop players to entertain us.